Alan Maryon-Davis on NHS carbon cutting

The weather may be hot - well, at least warm and wet on some days - but we all know the Big Freeze is uncomfortably close. With healthcare budgets soon to be locked in the chiller for years, and all the dilemmas about efficiency savings in the age of quality, is this really the time to try moving to a lower-carbon health service? Should it be a priority at all? And can anything we do make a difference?

Yes, yes and yes. Now is absolutely the right time, it should be very much a priority, and together we can have a profound and reverberating effect, across the UK and globally.

There will be more pressure on energy, water and waste disposal budgets, and this will hit the public sector as hard as the commercial world. Health service decision makers and managers need to start making the right moves now.

With the crucial global climate change discussions in Copenhagen this December, it is exactly the right time for the NHS to lead by example.

Climate change is the biggest threat to public health we face. The most vulnerable societies are suffering water shortages, crop failures, loss of grazing, forest fires, flash floods, coastal inundation and shifting vectors of disease. Whole populations are migrating to survive.

Closer to home we can expect more frequent and extreme heatwaves, more disruption from flooding, more skin cancer, more chest problems from air pollution, more food poisoning and more insect borne diseases. In 2003 the heatwave in Western Europe felled tens of thousands of frail elderly people. For public health, reducing carbon is as urgent a “must-do” as all the others on our list.

The NHS is in pole position to lead the way. Surveys show 63 per cent of the public feel it should do more to reduce its carbon footprint. Most NHS board chairs and chief executives want to see carbon reduction given a higher priority. New legally binding emission targets will soon come into play and the service will have to respond.

The NHS’s carbon footprint is gargantuan - nearly one thirtieth of the nation’s entire emissions. Around 60 per cent arises from procurement - the goods and services we use. Nearly a quarter (22 per cent) comes from the energy the NHS burns up for heat, light and power. And the rest is emitted by all the transport used by patients, visitors and staff. The health service is by far the biggest single public sector contributor to climate change in Europe. But that also means we can make a huge difference. And many carbon cutting initiatives can save money for patient care - some surprisingly quickly.

Moving ahead

Let’s encourage more walking, cycling and use of public transport, for patients and visitors as well as staff. Let’s press for safer walking and cycling routes and better connections to public transport. Where car use is unavoidable, let’s encourage journey sharing and fuel-efficient car pools. Let’s switch to greener patient transport fleets. Plus more teleconferencing instead of meetings; more home working for administrative staff; a shift of services closer to the patient, more telediagnosis; and more efficient appointments.

Huge savings can be gained through energy efficiency. New builds have to meet green standards, but more could be done in retro-fitting existing premises: better insulation, natural air circulation, window blinds, reflective glass, draught proofing, combined heat and power. The list goes on.

We can save masses on waste. Annually the service chucks out about 250,000 tonnes at a cost of over £40m, equivalent to about 3 per cent of NHS carbon emissions. This includes about 13 million patient meals.

You can find more examples in the NHS carbon reduction strategy, Saving Carbon, Improving Health, and checklists and weblinks in a guide, Sustaining a Healthy Future: special focus on the NHS, published by the UK Faculty of Public Health with the NHS Sustainable Development Unit and NHS Confederation.

Let’s all lean on the government to make sure a meaningful deal comes out of Copenhagen in December. You can help by clicking on the Climate and Health Council’s “pledge” button online to add your name to their petition.

Great lumbering giant that it is, the NHS is moving far too slowly and there is an ostrich-like collective burying of heads. This has to change. The NHS should be a shining low carbon beacon. Anything less would be a betrayal of our duty of care and our legacy to the health and wellbeing of future generations. Despite the tough financial outlook, we must act now.